Journal
BIOMATERIALS ADVANCES
Volume 142, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.bioadv.2022.213149
Keywords
Titanium dioxide; Nanotexturing; Rabbit iliac artery; Cobalt -chromium coronary stent; In-stent restenosis; Endothelialization
Categories
Funding
- Department of Biotechnology, Government of India [BT/PR3516/Med/32/192/2011]
- Indian Council of Medical Research
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Recent advances in coronary stents have shown that surface modification, such as titania nanotexturing, can enhance re-endothelialization and reduce restenosis. In this study, titania-coated cobalt-chromium stents with nanotopography were found to facilitate preferential cell response, leading to rapid re-endothelialization and minimal neointimal hyperplasia. These drug and polymer-free stents could potentially serve as an alternative to clinical drug-eluting stents.
Recent advances in coronary stents have all been distinctively focused towards directing re-endothelialization with minimal in-stent restenosis, potentially via alterations in surface topographical cues, for augmenting the efficacy of vascular implants. This perspective was proven by our group utilizing a simple and easily scalable nanosurface modification strategy on metallic stents devoid of any drugs or polymers. In the present work, we explore the impact of surface characteristics in modulating this cell response in-vitro and in-vivo, using titania coated cobalt-chromium (CC) stents, with and without nanotopography, in comparison to commercial controls. Interestingly, titania nanotopography facilitated a preferential cell response in-vitro as against the titania coated and bare CC surfaces, which can be attributed to surface topography, hydrophilicity, and roughness. This in turn altered the cellular adhesion, proliferation and focal contact formations of endothelial and smooth muscle cells. We also demonstrate that titania nanotexturing plays a pivotal role in fostering rapid re-endothelialization with minimal neointimal hyperplasia, leading to excellent in-vivo patency of CC stents post 8 weeks implantation in rabbit iliac arteries, in comparison to bare CC, nano-less titania coated CC, and commercial drug-eluting stents (CC DES), without administering antiplatelet agents. This exciting result for the drug and polymer-free titania nanotextured stents, in the absence of platelet therapy, reveals the possibility of proposing an alternative to clinical DES for coronary stenting.
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